Provider Demographics
NPI:1407877236
Name:ESTES, DEBRA LEIGH (LCSW-C)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LEIGH
Last Name:ESTES
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8009 MANDAN RD APT 201
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2861
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6301 IVY LN
Practice Address - Street 2:#700
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-1402
Practice Address - Country:US
Practice Address - Phone:202-494-8700
Practice Address - Fax:240-553-7854
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD111431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD400634800Medicaid